Pregnant women who are Jehovah's Witnesses are six times more likely to die during childbirth and three times more likely to have serious complications than the general population, according to a new study by Dutch researchers.
All of the cases of death examined by the researchers were caused by major obstetric hemorrhage, according to the study, and the refusal of red blood transfusions by the women was found to be "an important factor" in the deaths.

"Jehovah's Witnesses, by refusing blood transfusion, expose themselves to a serious risk during childbirth," said Jos van Roosmalen, supervisor of the research and chairman of the National Maternal Mortality Committee of the Netherlands Society of Obstetrics and Gynecology.

Most Jehovah's Witnesses refuse many types of blood transfusions, believing that the Bible warns against ingesting blood. Individual members, though, may differ from church teachings or use other medical means, such as receiving their own blood back in transfusions.

The Dutch report, published this month in BJOG: An International Journal of Obstetrics and Gynecology, examined all cases of maternal mortality in the Netherlands between 1983 and 2006, and all cases of serious maternal morbidity between 2004 and 2006.

"Any hospital treating Jehovah's Witnesses should have a clear protocol for obstetric care, and ensure training for staff in the management of obstetric hemorrhage in these patients," said Philip Steer, BJOG's editor-in-chief.

The Jehovah's Witnesses' U.S. office did not respond immediately for a request for comment.